Wasting Your Vitamins?
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Are you flushing away your vitamins?
Most likely…but you don’t have to.
We all know what a wasteful expense supplements can sometimes be, but you can optimise your intake to get more bang for your buck!
Top Tips for Getting Your Money’s Worth:
- Liquids are better than tablets—the body can’t absorb nutrients from tablets anywhere as easily as it can from liquids, with some saying as low as a 50% absorption rate for tablets, so if your supplement can come in drinkable form, take it that way!
- Capsules are better than tablets—capsules, depending on the kind, contain either a powder (true capsules) or a liquid (softgels). Once the capsule/softgel is broken down in the stomach, it releases its contents, which will now be absorbed as though you took it as a drink.
- Stay hydrated—on that note, your body can only make use of nutrients that it can easily transport, and if you’re dehydrated, the process is sluggish! Having a big glass of water with your supplements will go a long way to helping your body get them where they’re needed.
- Take with black pepper—studies disagree on exactly how much black pepper improves absorption of nutrients. Some say it improves it by 50%, others say as much as 7x better. The truth is probably that it varies from one nutrient to the next, but what is (almost) universally accepted is that black pepper helps you absorb many nutrients you take orally.
- Take with a meal—bonus if you seasoned it with black pepper! But also: many nutrients are best absorbed alongside food, and many are specifically fat-soluble (so you want to take a little fat around the same time for maximum absorption)
- Consider split doses—a lot of nutrients are best absorbed when spread out a bit. Why? Your body can often only absorb so much at once, and what it couldn’t absorb can, depending on the nutrient, pass right through you. So better to space out the doses—breakfast and dinner make for great times to take them.
- Consider cycling—no, not the two-wheeled kind, though feel free to do that too! What cycling means when it comes to supplements is to understand that your body can build a tolerance to some supplements, so you’ll get gradually less effect for the same dose. Combat this by scheduling a break—five days on, two days off is a common schedule—allowing your body to optimise itself in the process!
- Check Medications—and, as is always safe, make sure you check whether any medications you take can interrupt your supplement absorption!
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Surgery is the default treatment for ACL injuries in Australia. But it’s not the only way
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The anterior cruciate ligament (ACL) is an important ligament in the knee. It runs from the thigh bone (femur) to the shin bone (tibia) and helps stabilise the knee joint.
Injuries to the ACL, often called a “tear” or a “rupture”, are common in sport. While a ruptured ACL has just sidelined another Matildas star, people who play sport recreationally are also at risk of this injury.
For decades, surgical repair of an ACL injury, called a reconstruction, has been the primary treatment in Australia. In fact, Australia has among the highest rates of ACL surgery in the world. Reports indicate 90% of people who rupture their ACL go under the knife.
Although surgery is common – around one million are performed worldwide each year – and seems to be the default treatment for ACL injuries in Australia, it may not be required for everyone.
PeopleImages.com – Yuri A/Shutterstock What does the research say?
We know ACL ruptures can be treated using reconstructive surgery, but research continues to suggest they can also be treated with rehabilitation alone for many people.
Almost 15 years ago a randomised clinical trial published in the New England Journal of Medicine compared early surgery to rehabilitation with the option of delayed surgery in young active adults with an ACL injury. Over half of people in the rehabilitation group did not end up having surgery. After five years, knee function did not differ between treatment groups.
The findings of this initial trial have been supported by more research since. A review of three trials published in 2022 found delaying surgery and trialling rehabilitation leads to similar outcomes to early surgery.
A 2023 study followed up patients who received rehabilitation without surgery. It showed one in three had evidence of ACL healing on an MRI after two years. There was also evidence of improved knee-related quality of life in those with signs of ACL healing compared to those whose ACL did not show signs of healing.
Experts used to think an ACL tear couldn’t heal without surgery – now there’s evidence it can. SKYKIDKID/Shutterstock Regardless of treatment choice the rehabilitation process following ACL rupture is lengthy. It usually involves a minimum of nine months of progressive rehabilitation performed a few days per week. The length of time for rehabilitation may be slightly shorter in those not undergoing surgery, but more research is needed in this area.
Rehabilitation starts with a physiotherapist overseeing simple exercises right through to resistance exercises and dynamic movements such as jumping, hopping and agility drills.
A person can start rehabilitation with the option of having surgery later if the knee remains unstable. A common sign of instability is the knee giving way when changing direction while running or playing sports.
To rehab and wait, or to go straight under the knife?
There are a number of reasons patients and clinicians may opt for early surgical reconstruction.
For elite athletes, a key consideration is returning to sport as soon as possible. As surgery is a well established method, athletes (such as Matilda Sam Kerr) often opt for early surgical reconstruction as this gives them a more predictable timeline for recovery.
At the same time, there are risks to consider when rushing back to sport after ACL reconstruction. Re-injury of the ACL is very common. For every month return to sport is delayed until nine months after ACL reconstruction, the rate of knee re-injury is reduced by 51%.
For people who opt to try rehabilitation, the option of having surgery later is still there. PeopleImages.com – Yuri A/Shutterstock Historically, another reason for having early surgical reconstruction was to reduce the risk of future knee osteoarthritis, which increases following an ACL injury. But a review showed ACL reconstruction doesn’t reduce the risk of knee osteoarthritis in the long term compared with non-surgical treatment.
That said, there’s a need for more high-quality, long-term studies to give us a better understanding of how knee osteoarthritis risk is influenced by different treatments.
Rehab may not be the only non-surgical option
Last year, a study looking at 80 people fitted with a specialised knee brace for 12 weeks found 90% had evidence of ACL healing on their follow-up MRI.
People with more ACL healing on the three-month MRI reported better outcomes at 12 months, including higher rates of returning to their pre-injury level of sport and better knee function. Although promising, we now need comparative research to evaluate whether this method can achieve similar results to surgery.
What to do if you rupture your ACL
First, it’s important to seek a comprehensive medical assessment from either a sports physiotherapist, sports physician or orthopaedic surgeon. ACL injuries can also have associated injuries to surrounding ligaments and cartilage which may influence treatment decisions.
In terms of treatment, discuss with your clinician the pros and cons of management options and whether surgery is necessary. Often, patients don’t know not having surgery is an option.
Surgery appears to be necessary for some people to achieve a stable knee. But it may not be necessary in every case, so many patients may wish to try rehabilitation in the first instance where appropriate.
As always, prevention is key. Research has shown more than half of ACL injuries can be prevented by incorporating prevention strategies. This involves performing specific exercises to strengthen muscles in the legs, and improve movement control and landing technique.
Anthony Nasser, Senior Lecturer in Physiotherapy, University of Technology Sydney; Joshua Pate, Senior Lecturer in Physiotherapy, University of Technology Sydney, and Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Never Enough – by Dr. Judith Grisel
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We’ve reviewed books about addiction before—specifically about alcohol, at least. This one’s more general in that it covers different addictions.
On the other hand, it’s also more specific, in that it covers them from the author’s field: neuroscience.
…and experience too. The author had a plethora of addictions (the serious kind), got sober, and then undertook to study neuroscience. Her hope was to help others avoid, or escape from the same as‚ what she went through.
Dr. Grisel (as she now is) takes a methodical approach in this book. She works her way through the addictive mechanisms of a broad selection of common drugs, explaining each.
The focus here is on neutral explanations, rather than the propagandizing scaremongering that failed at least one generation. Why each drug is alluring, what it really does do—and the neurological price it exacts, down to the molecular level.
She also covers risk factors for addiction; genetic, epigenetic, and environmental. There’s no “if you were stronger”, or “these people made bad choices”, so much as… Many addicts were, in effect, sabotaged from before birth.
That doesn’t mean that to become addicted or not is just fate, but it does mean… There but for the grace of factors completely outside of our control go we.
Why is this useful to us, be we a reader without any meaningful addiction (we’re not counting coffee etc here)? Well, as this book illustrates and explains, many of us could be one (more) mishap away from a crippling addiction and not know it. Forewarned is forearmed.
Bottom line: almost all of us are, have been, or will be touched by addiction in some way. Either directly, or a loved one, or a loved one’s loved one, or perhaps a parent who gave us an epigenetic misfortune. This book gives understanding that can help.
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Fatty Acids For The Eyes & Brain: The Good And The Bad
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Good For The Eyes; Good For The Brain
We’ve written before about omega-3 fatty acids, covering the basics and some lesser-known things:
What Omega-3 Fatty Acids Really Do For Us
…and while we discussed its well-established benefits against cognitive decline (which is to be expected, because omega-3 is good against inflammation, and a large part of age-related neurodegeneration is heavily related to neuroinflammation), there’s a part of the brain we didn’t talk about in that article: the eyes.
We did, however, talk in another article about supplements that benefit the eyes and [the rest of the] brain, and the important links between the two, to the point that an examination of the levels of lutein in the retina can inform clinicians about the levels of lutein in the brain as a whole, and strongly predict Alzheimer’s disease (because Alzheimer’s patients have significantly less lutein), here:
Now, let’s tie these two ideas together
In a recent (June 2024) meta-analysis of high-quality observational studies from the US and around the world, involving nearly a quarter of a million people over 40 (n=241,151), researchers found that a higher intake of omega-3 is significantly linked to a lower risk of macular degeneration.
To put it in numbers, the highest intake of omega-3s was associated with an 18% reduced risk of early stage macular degeneration.
They also looked at a breakdown of what kinds of omega-3, and found that taking a blend DHA and EPA worked best of all, although of people who only took one kind, DHA was the best “single type” option.
You can read the paper in full, here:
Association between fatty acid intake and age-related macular degeneration: a meta-analysis
A word about trans-fatty acids (TFAs)
It was another feature of the same study that, while looking at fatty acids in general, they also found that higher consumption of trans-fatty acids was associated with a higher risk of advanced age-related macular degeneration.
Specifically, the highest intake of TFAs was associated with a more than 2x increased risk.
There are two main dietary sources of trans-fatty acids:
- Processed foods that were made with TFAs; these have now been banned in a lot of places, but only quite recently, and the ban is on the processing, not the sale, so if you buy processed foods that contain ingredients that were processed before 2021 (not uncommon, given the long life of many processed foods), the chances of them having TFAs is higher.
- Most animal products. Most notably from mammals and their milk, so beef, pork, lamb, milk, cheese, and yes even yogurt. Poultry and fish technically do also contain TFAs in most cases, but the levels are much lower.
Back to the omega-3 fatty acids…
If you’re wondering where to get good quality omega-3, well, we listed some of the best dietary sources in our main omega-3 article (linked at the top of today’s).
However, if you want to supplement, here’s an example product on Amazon that’s high in DHA and EPA, following the science of what we shared today 😎
Take care!
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The Truth About Vaccines
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The Truth About Vaccines
Yesterday we asked your views on vaccines, and we got an interesting spread of answers. Of those who responded to the poll, most were in favour of vaccines. We got quite a lot of comments this time too; we can’t feature them all, but we’ll include extracts from a few in our article today, as they raised interesting points!
Vaccines contain dangerous ingredients that will harm us more than the disease would: True or False?
False, contextually.
Many people are very understandably wary of things they know full well to be toxic, being injected into them.
One subscriber who voted for “Vaccines are poison, and/or are some manner of conspiracy ” wrote:
❝I think vaccines from 50–60 years ago are true vaccines and were safer than vaccines today. I have not had a vaccine for many, many years, and I never plan to have any kind of vaccine/shot again.❞
They didn’t say why they personally felt this way, but the notion that “things were simpler back in the day” is a common (and often correct!) observation regards health, especially when it comes to unwanted additives and ultraprocessing of food.
Things like aluminum or mercury in vaccines are much like sodium and chlorine in table salt. Sodium and chlorine are indeed both toxic to us. But in the form of sodium chloride, it’s a normal part of our diet, provided we don’t overdo it.
Additionally, the amount of unwanted metals (e.g. aluminum, mercury) in vaccines is orders of magnitude smaller than the amount in dietary sources—even if you’re a baby and your “dietary sources” are breast milk and/or formula milk.
In the case of formaldehyde (an inactivating agent), it’s also the dose that makes the poison (and the quantity in vaccines is truly miniscule).
This academic paper alone cites more sources than we could here without making today’s newsletter longer than it already is:
Vaccine Safety: Myths and Misinformation
I have a perfectly good immune system, it can handle the disease: True or False?
True! Contingently.
In fact, our immune system is so good at defending against disease, that the best thing we can do to protect ourselves is show our immune system a dead or deactivated version of a pathogen, so that when the real pathogen comes along, our immune system knows exactly what it is and what to do about it.
In other words, a vaccine.
One subscriber who voted for “Vaccines are important but in some cases the side effects can be worse ” wrote:
❝In some ways I’m vacd out. I got COVid a few months ago and had no symptoms except a cough. I have asthma and it didn’t trigger a lot of congestion. No issues. I am fully vaccinated but not sure I’ll get one in fall.❞
We’re glad this subscriber didn’t get too ill! A testimony to their robust immune system doing what it’s supposed to, after being shown a recent-ish edition of the pathogen, in deactivated form.
It’s very reasonable to start wondering: “surely I’m vaccinated enough by now”
And, hopefully, you are! But, as any given pathogen mutates over time, we eventually need to show our immune system what the new version looks like, or else it won’t recognize it.
See also: Why Experts Think You’ll Need a COVID-19 Booster Shot in the Future
So why don’t we need booster shots for everything? Often, it’s because a pathogen has stopped mutating at any meaningful rate. Polio is an example of this—no booster is needed for most people in most places.
Others, like flu, require annual boosters to keep up with the pathogens.
Herd immunity will keep us safe: True or False?
True! Ish.
But it doesn’t mean what a lot of people think it means. For example, in the UK, “herd immunity” was the strategy promoted by Prime Minister of the hour, Boris Johnson. But he misunderstood what it meant:
- What he thought it meant: everyone gets the disease, then everyone who doesn’t die is now immune
- What it actually means: if most people are immune to the disease (for example: due to having been vaccinated), it can’t easily get to the people who aren’t immune
One subscriber who voted for “Vaccines are critical for our health; vax to the max! ” wrote:
❝I had a chiropractor a few years ago, who explained to me that if the general public took vaccines, then she would not have to vaccinate her children and take a risk of having side effects❞
Obviously, we can’t speak for this subscriber’s chiropractor’s children, but this raises a good example: some people can’t safely have a given vaccine, due to underlying medical conditions—or perhaps it is not available to them, for example if they are under a certain age.
In such cases, herd immunity—other people around having been vaccinated and thus not passing on the disease—is what will keep them safe.
Here’s a useful guide from the US Dept of Health and Human Services:
How does community immunity (a.k.a. herd immunity) work?
And, for those who are more visually inclined, here’s a graphical representation of a mathematical model of how herd immunity works (you can run a simulation)!
Stay safe!
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What To Do If Having A Stroke Alone?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Thank you for the video about what to do if you have a heart attack alone, what about what to do if you have a stroke alone?❞
(for anyone who missed that video, here it is)
That’s a good question, especially as stroke risk is rising in the industrialized world in general, and the US in particular.
However, let’s start with the caveat that if you are having a stroke, there’s a good chance you will forget what we are about to say, what with the immediate effects it has on the brain. That said…
The general advice when it comes to looking after someone else who is experiencing a stroke, is, “don’t”.
In other words, call emergency services, and don’t do anything else, e.g:
- don’t give them anything to eat or drink
- don’t give them any medications
- don’t let them go to sleep
- don’t let them talk you out of calling emergency services
- don’t let them drive themselves to hospital
- don’t drive them to hospital yourself either*
*This is for two reasons:
- an ambulance crew has skills and resources that you don’t, and can begin treatment en-route, and also,
- not all hospitals have appropriate resources to treat stroke, so the ambulance crew will know to drive to one that does, instead of driving to a random hospital and hoping for the best
So, flipping this for if it’s you having the stroke, and you’re cognizant enough to remember this:
- do call an ambulance; stay on the line and don’t do anything else unless instructed by the emergency services.
In order to do that, of course it’s important to recognize the symptoms; you probably know these but just in case, the mnemonic is “FAST”:
- Face: is there weakness on one side of their face?
- Arms: if they raise both arms, does one drift downwards?
- Speech: if they speak, is their speech slurred or otherwise unusual?
- Time: to call emergency services
It’s great to not get caught out by surprise, so you might also want to check out:
6 Signs Of Stroke (One Month In Advance)
Take care!
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Water Fluoridation, Atheroma, & More
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝I watched a documentary recently on Fluoride in our drinking water & the dangers of it. Why are we poisoning our water?❞
This is a great question, and it certainly is controversial. It sounds like the documentary you watched was predominantly or entirely negative, but there’s a lot of science to back both sides of this, and it’s not even that the science is contradictory (it’s not). It’s that what differs is people’s opinions about whether benefiting one thing is worth creating a risk to another, and that means looking at:
- What is the risk associated with taking no action (error of omission)?
- What is the risk associated with taking an action (error of commission)?
The whole topic is worth a main feature, but to summarize a few key points:
- Water fluoridation is considered good for the prevention of dental cavities
- Water fluoridation aims to deliver fluoride and doses far below dangerous levels
- This requires working on consumer averages, though
- ”Where do we put the safety margins?” is to some extent a subjective question, in terms of trading off one aspect of health for another
- Too much fluoride can also be bad for the teeth (at least cosmetically, creating little white* spots)
- Detractors of fluoride tend to mostly be worried about neurological harm
- However, the doses in public water supplies are almost certainly far below the levels required to cause this harm.
- That said, again this is working on consumer averages, though.
- However, the doses in public water supplies are almost certainly far below the levels required to cause this harm.
- A good guide is: watch your teeth! Those white* spots will be “the canary in the coal mine” of more serious harm that could potentially come from higher levels due to overconsumption of fluorine.
*Teeth are not supposed to be pure white. The “Hollywood smile” is a lie. Teeth are supposed to be a slightly off-white, ivory color. Anything whiter than that is adding something else that shouldn’t be there, or stripping something off that should be there.
❝How does your diet change clean out your arteries of the bad cholesterol?❞
There’s good news and bad news here, and they can both be delivered with a one-word reply:
Slowly.
Or rather: what’s being cleaned out is mostly not the LDL (bad) cholesterol, but rather, the result of that.
When our diet is bad for cardiovascular health, our arteries get fatty deposits on their walls. Cholesterol gets stuck here too, but that’s not the main physical problem.
Our body’s natural defenses come into action and try to clean it up, but they (for example macrophages, a kind of white blood cell that consumes invaders and then dies, before being recycled by the next part of the system) often get stuck and become part of the buildup (called atheroma), which can lead to atherosclerosis and (if calcium levels are high) hardening of the arteries, which is the worst end of this.
This can then require medical attention, precisely because the body can’t remove it very well—especially if you are still maintaining a heart-unhealthy diet, thus continuing to add to the mess.
However, if it is not too bad yet, yes, a dietary change alone will reverse this process. Without new material being added to the arterial walls, the body’s continual process of rejuvenation will eventually fix it, given time (free from things making it worse) and resources.
In fact, your arteries can be one of the quickest places for your body to make something better or worse, because the blood is the means by which the body moves most things (good or bad) around the body.
All the more reason to take extra care of it, since everything else depends on it!
You might also like our previous main feature:
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